Defining Minimum Treatment Parameters of Ablative Radiation Therapy in Patients With Hepatocellular Carcinoma: An Expert Consensus

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dc.contributor.authorYanagihara, Ted K.
dc.contributor.authorTepper, Joel E.
dc.contributor.authorMoon, Andrew M.
dc.contributor.authorBarry, Aisling
dc.contributor.authorMolla, Meritxell
dc.contributor.authorSeong, Jinsil
dc.contributor.authorTorres, Ferran
dc.contributor.authorApisarnthanarax, Smith
dc.contributor.authorBuckstein, Michael
dc.contributor.authorCardenes, Higinia
dc.contributor.authorChang, Daniel T.
dc.contributor.authorFeng, Mary
dc.contributor.authorGuha, Chandan
dc.contributor.authorHallemeier, Christopher L.
dc.contributor.authorHawkins, Maria A.
dc.contributor.authorHoyer, Morten
dc.contributor.authorIwata, Hiromitsu
dc.contributor.authorJabbour, Salma K.
dc.contributor.authorKachnic, Lisa
dc.contributor.authorKharofa, Jordan
dc.contributor.authorKim, Tae Hyun
dc.contributor.authorKirichenko, Alexander
dc.contributor.authorKoay, Eugene J.
dc.contributor.authorMakishima, Hirokazu
dc.contributor.authorMases, Joel
dc.contributor.authorMeyer, Jeffrey J.
dc.contributor.authorMunoz-Schuffenegger, Pablo
dc.contributor.authorOwen, Dawn
dc.contributor.authorPark, Hee Chul
dc.contributor.authorSaez, Jordi
dc.contributor.authorSanford, Nina N.
dc.contributor.authorScorsetti, Marta
dc.contributor.authorSmith, Grace L.
dc.contributor.authorWo, Jennifer Y.
dc.contributor.authorYoon, Sang Min
dc.contributor.authorLawrence, Theodore S.
dc.contributor.authorReig, Maria
dc.contributor.authorDawson, Laura A.
dc.date.accessioned2025-01-20T17:05:30Z
dc.date.available2025-01-20T17:05:30Z
dc.date.issued2024
dc.description.abstractPurpose: External beam radiation therapy (EBRT) is a highly effective treatment in select patients with hepatocellular carcinoma (HCC). However, the Barcelona Clinic Liver Cancer system does not recommend the use of EBRT in HCC due to a lack of sufficient evidence and intends to perform an individual patient level meta -analysis of ablative EBRT in this population. However, there are many types of EBRT described in the literature with no formal definition of what constitutes "ablative." Thus, we convened a group of international experts to provide consensus on the parameters that define ablative EBRT in HCC. Methods and Materials: Fundamental parameters related to dose, fractionation, radiobiology, target identification, and delivery technique were identified by a steering committee to generate 7 Key Criteria (KC) that would define ablative EBRT for HCC. Using a modified Delphi (mDelphi) method, experts in the use of EBRT in the treatment of HCC were surveyed. Respondents were given 30 days to respond in round 1 of the mDelphi and 14 days to respond in round 2. A threshold of >= 70% was used to define consensus for answers to each KC. Results: Of 40 invitations extended, 35 (88%) returned responses. In the first round, 3 of 7 KC reached consensus. In the second round, 100% returned responses and consensus was reached in 3 of the remaining 4 KC. The distribution of answers for one KC, which queried the a/b ratio of HCC, was such that consensus was not achieved. Based on this analysis, ablative EBRT for HCC was defined as a BED10 >= 80 Gy with daily imaging and multiphasic contrast used for target delineation. Treatment breaks (eg, for adaptive EBRT) are allowed, but the total treatment time should be <= 6 weeks. Equivalent dose when treating with protons should use a conversion factor of 1.1, but there is no single conversion factor for carbon ions. Conclusions: Using a mDelphi method assessing expert opinion, we provide the first consensus definition of ablative EBRT for HCC. Empirical data are required to define the a/b of HCC. (c) 2023 Published by Elsevier Inc. on behalf of American Society for Radiation Oncology.
dc.fuente.origenWOS
dc.identifier.doi10.1016/j.prro.2023.08.016
dc.identifier.issn1879-8500
dc.identifier.urihttps://doi.org/10.1016/j.prro.2023.08.016
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/90722
dc.identifier.wosidWOS:001208853300001
dc.issue.numero2
dc.language.isoen
dc.pagina.final145
dc.pagina.inicio134
dc.revistaPractical radiation oncology
dc.rightsacceso restringido
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleDefining Minimum Treatment Parameters of Ablative Radiation Therapy in Patients With Hepatocellular Carcinoma: An Expert Consensus
dc.typeartículo
dc.volumen14
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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